EP2187847A1 - Faezes-managementsystem - Google Patents

Faezes-managementsystem

Info

Publication number
EP2187847A1
EP2187847A1 EP08784454A EP08784454A EP2187847A1 EP 2187847 A1 EP2187847 A1 EP 2187847A1 EP 08784454 A EP08784454 A EP 08784454A EP 08784454 A EP08784454 A EP 08784454A EP 2187847 A1 EP2187847 A1 EP 2187847A1
Authority
EP
European Patent Office
Prior art keywords
fecal
management system
receiving bag
fecal management
bag
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP08784454A
Other languages
English (en)
French (fr)
Inventor
Peter MÜLLEJANS
Michael Hansen
Troels Johansen
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Coloplast AS
Original Assignee
Coloplast AS
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Coloplast AS filed Critical Coloplast AS
Publication of EP2187847A1 publication Critical patent/EP2187847A1/de
Withdrawn legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/44Devices worn by the patient for reception of urine, faeces, catamenial or other discharge; Portable urination aids; Colostomy devices
    • A61F5/451Genital or anal receptacles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/44Devices worn by the patient for reception of urine, faeces, catamenial or other discharge; Portable urination aids; Colostomy devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/44Devices worn by the patient for reception of urine, faeces, catamenial or other discharge; Portable urination aids; Colostomy devices
    • A61F5/4404Details or parts
    • A61F5/4408Means for securing receptacles or bags to the body otherwise than by adhesives, e.g. belts, straps or harnesses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/44Devices worn by the patient for reception of urine, faeces, catamenial or other discharge; Portable urination aids; Colostomy devices
    • A61F5/441Devices worn by the patient for reception of urine, faeces, catamenial or other discharge; Portable urination aids; Colostomy devices having venting or deodorant means, e.g. filters ; having antiseptic means, e.g. bacterial barriers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/44Devices worn by the patient for reception of urine, faeces, catamenial or other discharge; Portable urination aids; Colostomy devices
    • A61F5/443Devices worn by the patient for reception of urine, faeces, catamenial or other discharge; Portable urination aids; Colostomy devices having adhesive seals for securing to the body, e.g. of hydrocolloid type, e.g. gels, starches, karaya gums

Definitions

  • the present invention relates to a fecal management system for collecting fecal matter from the rectum.
  • Bedridden persons for example persons being hospitalized, especially trauma patient who may not be fully conscious often suffer from fecal incontinence.
  • people having an ostomy are often not capable of controlling their discharge. This may understandably result in very unhygienic situations and it is therefore desirable to control the fecal discharges and in particular prevent these discharges from entering the ambient environment, such as a person's bed.
  • ostomy bags have been provided for ostomy users and fecal collecting bags for application around the rectum of anal incontinent persons.
  • US 4,784,656 discloses a receptacle for collecting fecal matter from incontinent patients and in particular bedridden incontinent patients.
  • the present invention relates to a fecal management system (hereinafter also referred to as the system) for collecting fecal matter from the rectum.
  • the system comprises a first fecal receiving bag extending in a flow direction between a first proximal opening attachable around the rectum and a closable first distal opening.
  • the system further comprises a second fecal receiving bag having an elongated section extending in the flow direction between a second proximal opening and a reservoir section.
  • the reservoir section extends in the flow direction between the elongated section and a distal end.
  • the first distal opening is connectable to the second proximal opening.
  • the first fecal receiving bag can be produced as a compact and portable device. This allows for the user to move around as fecal matter will be collected in the first fecal receiving bag and thereby avoiding any embarrassing accidents.
  • the second fecal receiving bag can be coupled to the first fecal receiving bag. This allows for additional capacity for collecting e.g. nightly stools.
  • the second fecal receiving bag is usually not intended to be carried around, thus, it may be provided with a much larger volume capacity than the first fecal receiving bag.
  • the elongated section allows for the reservoir section to be placed away from the user.
  • the elongated section has a length which allows for the reservoir section to be placed beyond the knee of the user, preferably it may also be extended to the side of the bed where the reservoir section can be hung so that a caregiver easily may observe the amount of fecal matter collected.
  • a closable second distal opening may be provided at the distal end of the reservoir section. This allows for the second fecal receiving bag to be emptied or allowing a caregiver to take samples.
  • the receiving bags can be made of many different materials suitable for containing and handling fecal matter in a leak proof and odor free manner.
  • the receiving bag may be formed of extruded materials.
  • materials suitable for extrusion tend to be elastic and have to be relative thick in order not transmit odor. Such thick materials will provide bulkier receiving bags that consequently are uncomfortably to wear or lie on.
  • the first fecal receiving bag and the second fecal receiving bag is formed of a first sheet wall and a second sheet wall attached to each other along their periphery and additionally may be formed of non-elastic materials.
  • sheet walls in order to form the receiving bags it is possible to use materials that are relative thin compared to extruded materials while still having odor-proof properties.
  • the sheet walls can be for example welded or glued together, or attached in any other way known to the person skilled in the art.
  • the first and second sheet wall can be a polymer foil sheet.
  • the first and second sheet wall can comprise a layered structure of different sheet materials.
  • the outer layer of at least one of the first and second sheet wall is a non-woven material. This provides for an outer layer that is comfortable to the touch and suitable to be arranged along a limb, such as the leg, of a user.
  • the non-woven material may have moisture-dispersing properties. This gives a comfortable and dry feel; especially as a wet feel might unnecessarily have the user worry that a leak has occurred.
  • the receiving bags may be provided with different handling features, for example ears, which are small protruding flanges that are large enough for a person to hold on to by squeezing a pair of fingers on each side of said flange/ear.
  • the second proximal opening is provided with a planar coupling member having a handling ear arranged at one side.
  • the second fecal receiving can be arranged on the side of the bed so that a caregiver may monitor it.
  • the second fecal receiving bag may be provided with at least one through going support hole along its periphery which allows for the second receiving bag to be hung on a hook or similar hanging arrangement.
  • a scale is provided on the side of the second fecal receiving device so that the caregiver can see if it is time to empty or change the receiving device.
  • Such a scale can for example be provided with a number of lines having text indicating the level and amount of fecal matter present in the bag at that line.
  • an adhesive wafer can be attached around the first proximal opening.
  • the adhesive wafer can furthermore be folded back around a folding axis across the adhesive wafer. This allows for an adhesive wafer that is easier to place between the buttocks of a user compare to a planar flat adhesive wafer.
  • the adhesive wafer can be attached to the first fecal receiving bag at an angle different from 0° (i.e. parallel) between the center axis of the first proximal opening and the flow direction. It has shown choosing an angle of 35° can accommodated a large group of users.
  • the first fecal receiving bag is provided with a leg strap which supports the bag in its place and distributes some of the stress from the first proximal opening to the strap.
  • the elongated and alternatively part of the reservoir section can be provided with at least a first and a second elongated support strips extending along the longitudinal extent of the elongated section.
  • the strips supports and maintains the shape of the elongated section and reduces the risk that it become bent or twisted.
  • the elongated support strips may moreover be formed of a resilient material. This allows for a comfortable feel for example if the user lies on the elongated section while it will return to its original state when the user moves away.
  • the elongated support strips may be provided in many different ways, for example on the outside of the elongated section, within separate compartments or they may be arranged within the lumen of the elongated section. Where they are provided within the lumen a simple construction may be provided wherein a single continuous welding process may create the second fecal receiving bag.
  • the elongated section When the elongated section is arranged on e.g. on a linen on the surface of a bed it should move around as little as possible in order to prevent kinking and twisting.
  • the elongated support strips By attaching the elongated support strips on the part of the elongated section which touches the surface of the bed they tend to move less around than if one or both were arranged on the opposite side (not lying on the bed surface).
  • the elongated support strips may be arranged on one bisection of the elongated section. It should be understood that a bisection is the section you obtain when an element is cut or divided into two equal or nearly equal parts, e.g. one of the sheets if the fecal receiving bag is formed of two sheet welded together.
  • the first fecal receiving bag may comprise a filter arrangement allowing gas to escape the first fecal receiving bag. Furthermore, as the first fecal receiving bag also is adapted to wear while walking and standing up the filter arrangement may be placed in proximity of the first proximal opening. This avoids that the fecal matter closes of the filter arrangement, as the fecal matter will move towards the closable first distal opening.
  • Fig. 1 shows a first fecal receiving bag as used in a fecal management system as disclosed herein,
  • Fig. 2 shows a second fecal receiving bag as used in a fecal management system as disclosed herein
  • Fig. 3a - 3c show in cross section the elongated section of the second fecal receiving bag
  • Fig. 4 - 7 show a user wearing the first fecal receiving bag
  • Fig. 8 and 9 show the fecal management system in use.
  • a first fecal receiving bag 1 is shown in fig. 1.
  • the first bag extends between a first proximal opening 2 and a first distal opening 3 in a flow direction indicated by the solid arrow and which is parallel to the general axis A - A of the first fecal receiving bag.
  • the bag is formed of a first proximal sheet wall 4 and a first distal sheet wall 5 (not seen in fig.1 ). The two sheet walls are welded together along their periphery along first weld 6.
  • An adhesive wafer 7 is attached to the first fecal receiving bag 1 and is arranged around the first proximal opening 2 having a center axis B - B.
  • a first through going hole 8 is formed in the adhesive wafer allowing communication in or out of the first bag through the first through going hole 8 and the first proximal opening 2.
  • the adhesive wafer may be formed of a hydrocolloid adhesive much like the ones used for ostomy appliances that are very skin friendly and adhere well to the surface of the skin.
  • the adhesive wafer is bent around a symmetric axis and is folded around so that the symmetrical halves touches or almost touches each other. This provides an adhesive wafer that is well suited for adhering around the rectum as it is easily inserted between and adhered to the buttocks.
  • the adhesive wafer is attached around the first proximal opening 2.
  • the adhesive wafer 7 may be arranged on the first fecal receiving bag so that an angle ⁇ is formed between the general axis A - A and the center axis B - B of the first proximal opening which is different from 0 ° (i.e. not parallel). In the embodiment shown it is 35 ° , however it may be between 0 ° and 90 ° , in particular between 30 ° and 40 ° .
  • a filter arrangement 9 is provided in the proximal sheet wall 4 close to the adhesive wafer.
  • the filter arrangement allows gasses to escape from the first fecal receiving bag while at the same time cleaning the gasses for odors.
  • Filter arrangement known within ostomy appliances that fulfill the same requirements may be used for this purpose.
  • a first planar coupling member 10 is attached to the first fecal receiving bag 1 and is arranged around the first distal opening 3.
  • a second through going hole 11 is formed in the first planar coupling member allowing communication in or out of the first bag through the second through going hole 11 and the first distal opening 3.
  • the first planar coupling member 10 allows the first fecal receiving bag to be closed and opened in order to empty the receiving bag.
  • Such feature in relation to the present construction is known as Hide-away® outlet produced by Coloplast A/S and which is described in WO 99/66859.
  • further utility of the first planar coupling member may be provided, as the planar coupling member also can function as a coupling element coupling first receiving bag with another receiving bag as will be described.
  • first planar coupling member When functioning as a closure the first planar coupling member is folded around the elongated opening and rolled up so that it is aligned with first and second locking strip 12 and 13. Such folding also moves the first Velcro® loop patch 14, which is arranged on the distal sheet wall up in alignment with the first and second locking strips. On the first and second locking strip 12, 13 there is arranged first and second Velcro® hook patches 15, 16 respectively. As the first Velcro® loop patch 14 is folded into alignment with the locking strips, the locking strips are folded around and attached to the Velcro® loop patch by the first and second Velcro® hook patches and thus, the first fecal receiving bag may be held in a closed configuration.
  • a leg strap 17 is attached to the first fecal receiving bag.
  • the leg strap is attached around the thigh of the user. This holds the bag in place so that it does not dangles and swings around uncontrollably which causes discomfort to the user.
  • the leg strap also serves to relieve some of the stress that would otherwise be exerted on the adhesive wafer. Excess stress on the adhesive wafer may result in that the adhesive wafer detaches partly or fully from the skin around the rectum.
  • the sheet walls 4,5 may be partly (shown in the figures) or fully covered by an outer non-woven layer 18. This provides a pleasant feel and thus does not irritate the user as the sides of the first fecal receiving bag often will abut against the skin of the legs.
  • the folded and closed first planar coupling member may be folded further up and hidden under the outer non-woven layer 18. It is held in place by attaching the first Velcro® loop patch 14 to a third Velcro® hook patch 19 arranged partly under the non-woven layer. From the above it can be understood that the first Velcro® loop patch 14 has a size which allows the first, second and third Velcro® hook patches to be attached thereto.
  • a second fecal receiving bag 20 is shown in fig. 2.
  • the second fecal receiving bag is formed of an elongated section 21 and a reservoir section 22.
  • the elongated section 21 extends from a second proximal opening 23 to the reservoir section 22.
  • a second planar coupling member 24 is arranged around the second proximal opening and a third through going hole 25 formed in the second planar coupling member allowing communication in or out of the second fecal receiving bag through the third through going hole 25 and the second proximal opening 23.
  • the second planar coupling member serves to couple the first and second receiving bag together in a leak and odor tight coupling arrangement. This is done by aligning the second and third through going holes folding the first and second planar coupling member around the second and third through going hole.
  • the coupling members are then secured in this arrangement by folding third and fourth locking strips 26, 27 respectively around the planar coupling members and attaching them to the back of the second planar coupling member via fourth and fifth Velcro® hook patches 28, 29.
  • This type of coupling arrangement provides a flat and secure, i.e. leak and odor tight, connection between the two receiving bags.
  • other coupling arrangements may be anticipated.
  • the elongated section serves as an extension element to allow the reservoir section to be placed away from the first fecal receiving bag while still being in communication hereto.
  • the first fecal receiving bag and the receiving section may serve as containers for storing and collecting fecal matter and thus have a large capacity relative to the elongated section which serves as an intermediate conveying element.
  • the construction and placement of the elongated section will often make it prone to kinking, twisting and other effects that cut off the flow of fecal matter.
  • first and second support strip 30, 31 is arrangement within the elongated section. These strips run within the elongated section for the majority of the extent between the second proximal opening and the reservoir section. The support strips will keep the walls of the elongated section apart allowing better flow while also reducing the risk that the elongated section is twisted and/or bent into a kink.
  • the elongated section may be squeezed by the leg of an user or a caregiver or the user may want to force fecal matter through the elongated section.
  • the support strips may be formed of a compressible material.
  • they may be formed of a resilient material which after compression allows it to return to its initial expanded configuration.
  • the elongated section communicates with the reservoir section, which extends from the elongated section to a second distal opening 32.
  • a closable arrangement similar to that around the fist distal opening 3 of the first fecal receiving bag is provided around the second distal opening 32.
  • the second fecal receiving bag may be emptied when full.
  • Like reference numbers followed by a mark (') has been used for the element forming the closable arrangement that are similar to that of the first fecal receiving bag.
  • a third planar coupling member 10' is arranged around the second distal opening 32.
  • a third through going hole 11 ' is formed in the third planar coupling member allowing communication with the reservoir section.
  • fifth and sixth locking strips 12', 13'; second Velcro® loop patch 14'; and sixth, seventh and eight Velcro® loop patches 15',16',19' has been provided.
  • the second fecal receiving bag is also formed of a second proximal sheet wall 33 and a second distal sheet wall 34 (not seen in fig. 2).
  • the two sheet walls are welded together along their periphery along second weld 35.
  • FIG. 3a A cross section along the line III - III in fig. 2 is shown in fig. 3a.
  • the elongated section 21 is formed of the second proximal sheet wall and the second proximal sheet wall that are welded together.
  • First and second support strips 30, 31 are attached to the second distal sheet wall 34 on the surface inside the lumen of the elongated section.
  • the support strips can be attached in many ways, for example welding or gluing.
  • the elongated section is arranged so that the second distal sheet wall lies on the surface of a bed 40. This provides a solution where the risk of the elongated section is reduced as the support strips will not slide back and forth since they are frictional engaged to the surface of the bed via the second distal sheet wall.
  • first and second support strip can be seen in fig. 3b where the first support strip is arranged on the second proximal sheet wall and the second support strip is arranged on the second distal sheet wall; and in fig. 3c where the support strips are arranged inside first and second separate channels 36, 37 running parallel with the elongated section.
  • Figures 4 - 7 shows different situation wherein a user is using a first fecal receiving bag 1.
  • the first fecal receiving bag is formed so that it can be worn on the inside of the thigh of a user.
  • different sizes of bags may be required for different people.
  • a bag having a length of 270mm and a width of 130mm will satisfy a majority of people.
  • these dimension provides a total volume of 780ml the buttocks will squeeze the upper area around the adhesive wafer so that the volume is reduced to an effective 300ml.
  • 300ml is sufficient to allow a user to move around for an extended period time, from a few hours up to a day, without having to worry about changing or emptying the first fecal receiving bag.
  • Fig 4 shows a user who is walking around.
  • the first fecal receiving bag 1 fits nicely under a pair of shorts 50 or other garment such as a dress or pair of pants.
  • the leg strap 17 holds the bag in place along the thigh avoiding that the bag starts swinging out of rhythm with the users walking pace.
  • the leg strap support the first fecal receiving bag taking some of the stress that would otherwise be exerted on the adhesive wafer 7.
  • the bag will follow orientation of the thigh and be kept between the legs in a comfortable position where the user does not risk sitting on it or it gets squeezed between objects. Furthermore as the user lies down as shown in fig. 6 the receiving bag will lie safely between the legs avoiding that it gets squeezed between the user and the bed as the user turns during the night.
  • Fig. 7 shows how the user easily empties the first fecal receiving device. Before he sits down on the he removes the leg strap. When seated he can then open the first distal opening 3 and by stroking his hand along the sides of the first fecal receiving bag the fecal matter contained in the bag will be squeezed out. Using a piece of toilet paper he can then easily clean the first planar coupling member 10 and close the first distal opening 3.
  • a second fecal receiving device be may attached to the first fecal receiving device as an extension member.
  • the second fecal receiving device has a capacity that is much larger than the first fecal receiving device, e.g. 2 litres. This allows for a user to have a full nights sleep and caregivers does not have to attend the user as often.
  • such second fecal receiving bag may be connected to the first fecal receiving bag via an extension section.
  • such extension section allows the second fecal receiving device to be hung on the side of the bed so that caring personal may easily monitor the volume of fecal matter in the second bag without having to trouble user.
  • the second fecal receiving bag is full the whole arrangement, e.g. both the first fecal receiving bag and the second fecal receiving , may be exchanged or only the second fecal receiving bag may be exchanged.
  • a closable opening may also be provided on the second fecal receiving bag allowing it to be emptied without detaching it from the first fecal receiving bag.

Landscapes

  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Epidemiology (AREA)
  • Nursing (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Dispersion Chemistry (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
EP08784454A 2007-08-10 2008-08-08 Faezes-managementsystem Withdrawn EP2187847A1 (de)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DKPA200701139 2007-08-10
PCT/DK2008/050196 WO2009021520A1 (en) 2007-08-10 2008-08-08 Fecal management system

Publications (1)

Publication Number Publication Date
EP2187847A1 true EP2187847A1 (de) 2010-05-26

Family

ID=39115048

Family Applications (1)

Application Number Title Priority Date Filing Date
EP08784454A Withdrawn EP2187847A1 (de) 2007-08-10 2008-08-08 Faezes-managementsystem

Country Status (8)

Country Link
US (1) US20110137273A1 (de)
EP (1) EP2187847A1 (de)
JP (1) JP2010535547A (de)
CN (1) CN101778609B (de)
AU (1) AU2008286509A1 (de)
BR (1) BRPI0815344A2 (de)
CA (1) CA2696025A1 (de)
WO (1) WO2009021520A1 (de)

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Also Published As

Publication number Publication date
CA2696025A1 (en) 2009-02-19
WO2009021520A1 (en) 2009-02-19
CN101778609A (zh) 2010-07-14
CN101778609B (zh) 2011-12-07
AU2008286509A1 (en) 2009-02-19
US20110137273A1 (en) 2011-06-09
JP2010535547A (ja) 2010-11-25
BRPI0815344A2 (pt) 2015-02-10

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